Wednesday, 19 November 2008

Why Aren't GP Mental Health Referrals Hitting The Spot?

Today has been another day of blurred vision and very sore eyes. Reading has been difficult, and knitting all but impossible.  All of this means that I've been feeling low again.  

I have, however, been able to keep up to date with the blogs that I read on a regular basis, mainly because I can enlarge them enough to make reading them easy.  Two of these bloggers, Jobbing Doctor and Geepeemum have written about the difficulties of referring patients with psychiatric problems to see consultant psychiatrists or getting help from mental health crisis teams. These are problems that are often written about by bloggers with mental health problems too.

I have been relatively lucky when I have been referred for specialist help, but I am well aware that this has been the exception rather than the rule as far as mental health patients are concerned.  In the early days of my problems I was living in Cambridgeshire.  Whenever my GP referred me to see a psychiatrist I saw one, but that was in part because the psychiatrist was a personal friend of my GP, who was also the psychiatrist's GP, so my referral possibly did not have to face the hurdles that other referrals may have encountered.  But even though I saw the consultant psychiatrist whenever my GP considered it necessary, it did not mean that I necessarily got the best help from other mental health professionals.  This was particularly the case with the CPN who caused me so much angst that I came close to suicide after seeing her for a number of appointments.

Since moving back to London I have been referred by my GP for psychotherapy, and again I have been lucky.  I happen to live in an area of London which is served by a well known psychiatric hospital which happens to have a fairly large psychotherapy department.  Even so, I was warned when my GP made the initial referral that it could be a long time before I had an assessment, let alone received psychotherapy.  Luck was again on my side because I had an appointment for assessment within a few weeks of the referral and once it was decided that I was a suitable case for treatment (such a brilliant film title, and one that I have always wanted to use when writing on this subject) I was again warned that it would be many months, perhaps even a year, before a psychotherapist was available.  Fortunately I didn't have to wait too long for a psychotherapist to have a vacancy, and I have now been going for psychodynamic psychotherapy for six months now.

I know that I have been very lucky with the referrals and the treatment that I have received.  The problem is that not everyone who needs this kind of help is quite as lucky as I have been.  If certain cancer drug treatments are considered to be a post code lottery, then specialist treatment for those who suffer mental health problems is even more so.  Treatment should not be a last resort; it should not be necessary for someone to have to admitted to hospital in order to get the treatment that they should be getting as a right.

If the money that has been wasted so far on the infamous Connecting for Health had been put into Mental Health, then perhaps there might not be quite so many bloggers bemoaning how they feel that they have been abandoned by the NHS because they have a mental illness rather than ordinary physical illnesses. And the problem is that we are only the tip of the iceberg as far as people who need this help are concerned.

The government keep telling us that it is wrong to discriminate against those with mental health problems, and yet they themselves are doing just that by not making sure that this country's mental health services are properly funded and available to all those in need of help.


cbtish said...

Some of your experiences are similar to others I've come across. Referrals to a psychiatrist can go straight through when the GP knows the psychiatrist, but there can be a delay if the GP's referral is not so specific.

And in general mental health professionals (psychiatrists included) provide very variable quality. Some of them seem dangerously ineffective.

But as for funding, I'm not so sure that throwing money at the problem will help. From my viewpoint (in the private sector) I see huge waste of resources in the NHS. Every ineffective CPN, for example, costs the NHS a fortune by keeping patients ill instead of helping them to get better. I don't see the kind of quality control that would enable mental health trusts to spend extra money wisely, and I would be wary of rewarding them for failure.

Disillusioned said...

Particularly in terms of access to CMHT support and psychotherapy, this rings so very, very true for me. On so many occasions, health professionals who have met me have strongly recommended that i get support. On so many occasions, CMHT staff who have never met me have turned down or delayed this recommendation. The end result is that I have ended up feeling rejected and unworthy of help.